Gynaecological problems it’s always worth getting checked

By Lisa Salmon

Everything from embarrassment to not knowing what’s normal can mean some women don’t seek help for gynaecological problems – potentially putting them at risk of their symptoms worsening or becoming much more serious.

Research by the Royal College of Obsetricians and Gynaecologists found a quarter (24 per cent) of women feel unable to seek care because of embarrassment about their condition, and to make matters worse, many have been avoiding visiting their GP because of the pandemic.

In a bid to help women understand what gynaecological symptoms may be need checking, The Eve Appeal and Dr Anita Mitra, aka the Gynae Geek, have launched the new Be Gynae Aware campaign, which includes a checklist of gynae issues it’s advisable to keep track of.

“There’s a huge lack of knowledge around gynaecological anatomy and symptoms – women are often woefully unaware of what’s going on inside their own pelvis and between their legs,” says The Eve Appeal chief executive, Athena Lamnisos.

“Worrying symptoms may not be cancer – but it’s always best to rule out the most concerning things as early as possible. Early diagnosis, and wherever possible, prevention, is so important.”

Here, Mitra talks us through what’s on the Be Gynae Aware checklist…

Abnormal bleeding

“There’s no such thing as a ‘period’ after the menopause, and this should always be investigated, as should bleeding after sex and between periods,” advises Mitra, who says less sinister causes of abnormal bleeding may be polyps, cervical ectropion (cells growing outside the cervix), or atrophic changes (thinning, drying and inflammation of the vagina related to lack of oestrogen).

Pelvic/abdominal pain

This may need investigating if it’s different from your normal period pain. Mitra says: “Pelvic pain can be sporadic or associated with certain activities, such as sex or going to the toilet. It may happen at certain times in your menstrual cycle, so it’s worth keeping a note of this.”

Menstrual cycle changes

Changes in your menstrual cycle may relate to its length, volume of blood, or cramps. Mitra says it’s worth consulting a doctor if your periods become much heavier or much more painful.

Common causes of menstrual changes may be polycystic ovarian syndrome, endometriosis, adenomyosis, polyps, or the menopause.

Pain during sex

Mitra explains that pain during sex may be superficial – for instance, on the outside, making penetration painful or impossible, or deep on the inside during or after penetration. But either way, it may need investigating. Common less sinister causes could be endometriosis, fibroids, cysts, vaginismus, vulval skin conditions, or even constipation.

Change in discharge

Mitra says this may be a change in colour, blood-staining, itchiness, or the discharge may smell bad. “Again, it’s worth keeping a note if there are any connections to certain times in the menstrual cycle,” she advises. Changes in discharge are most commonly related to infections.

Skin changes/lumps on the vulva

The vulval skin can become very pale, pigmented (coloured) areas may arise, or it can become red or flaky, says Mitra, who warns women not to ignore such changes, or any lumps in the area. “Lumps or bumps may be felt, and these can bleed or have discharge coming from them,” she explains. Most commonly, such changes are linked to thrush, dermatitis, folliculitis, lichen sclerosus or atrophic changes.

Itching pain/swelling of the vulva or vagina

Vulval itching can occur alongside or independent of skin changes, says Mitra, and may also be associated with a change in discharge. Common causes are thrush, infections or lichen sclerosus.

Persistent bloating

This is when your abdomen is constantly bloated, and doesn’t seem to change according to the time of day, or have any relation to food. Mitra warns: “This can arise from big masses such as huge fibroids, cysts or tumours, but also if you have ovarian cancer because your abdomen can become full of fluid.”

Change in bowel/urine habits

Symptoms linked to the bowel and bladder aren’t always immediately thought to be connected to gynae health. However, Mitra explains: “Our bowel and bladder lie right next to the uterus and ovaries, so if there’s pressure from these things they can cause changes in the bladder or bowels, such as needing to pass urine more often than normal, incomplete emptying of your bladder so you feel like you need to go again right after you’ve already been, constipation or even diarrhoea.”

Common reasons for such changes may include urine infections, IBS, large fibroids or endometriosis.